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Saturday, September 18, 2010

In India, no dignity in dementia

Way back in 2007, scientists from Johns Hopkins University concluded at the Alzheimer's Association conference in Washington that over 26 million people worldwide have Alzheimer's disease - a number set to quadruple by 2050. The prediction shocked the world as it woke up to the menace of this braindestroying condition.

Two years later, the definitive World Alzheimer's report, compiled by the world's top dementia scientists, admitted that the problem was much worse. Their conclusion was that 35 million people worldwide would be suffering from dementia (90 per cent of which were Alzheimer's cases) in 2010 and that the number is set to almost double every 20 years to 65. 7 million in 2030 and 115. 4 million in 2050. Several countries woke up and started to put in place services for the old, like homes to support dementia patients, screening programmes and treatment protocols. India, however, didn't bother to take any such action.

Today, an estimated 37 lakh people in India are affected by dementia, which is expected to double by 2030. Despite the magnitude, there is gross ignorance and neglect, and services are scarce for people with Alzheimer's and their families. According to a landmark "India Dementia Report 2010", which will be released on September 21 by Alzheimer's and Related Disorders Society of India (ARDSI) - and is now exclusively available with TOI-Crest - it is estimated that the cost of taking care of a patient with Alzheimer's is about Rs 43, 000 annually, much of which is met by the families.According to Dr Daisy Acosta, chairman of Alzheimer's Disease International (ADI), the costs of caring for Alzheimer's sufferers is likely to rise even faster than the disease's prevalence - especially in the developing world. "This is a wake-up call that Alzheimer's is the single most significant health and social crisis of the 21st century, " said Dr Acosta. "World governments are woefully unprepared for the social and economic disruptions this disease will cause, " she added.

Alzheimer's is a chronic syndrome characterised by a progressive deterioration in intellect including memory, learning, orientation, language, comprehension and judgement. It mainly affects older people;only about 2 per cent of cases start before the age of 65 years. After this, the prevalence doubles every five years, becoming one of the major causes of disability in late-life.

Experts say India was home to more than 75 million people older than 60 years in 2001. This age group, which was 7. 5 per cent of the population, is growing. Significant demographic ageing with the elderly population now above 8 per cent has been seen in Himachal Pradesh (9), Punjab (9), Maharashtra (8. 7), Tamil Nadu (8. 8), Orissa (8. 3), Goa (8. 3), and Pondicherry (8. 3). "The demand for geriatric services, related to dementia, will soon be overwhelming, " Dr Roy says.

Dr J D Mukherji, head of neurology at Max Hospital, Delhi, said the biggest problem in India is that public awareness about Alzheimer's is low and this has serious consequences. "Soon, we will have plaque-blasting medicines that can delay Alzheimer's by causing plaque deposits to integrate. So early diagnosis is vital. At present, diagnosis is largely missed, mainly in non-metropolitan centres. The government needs to initiate awareness about dementia and introduce its study at the undergraduate level for medical students, " Dr Mukherji said.

According to the India Dementia report, no structured training exists on the recognition and management of dementia at any level of health service. PwD are stigmatised because the underlying cause is not understood. According to the World Alzheimer's report 2009, "The healthcare needs of older people have for too long been under-prioritised. This is now changing due in part to the fact that demographic ageing of population is proceeding more rapidly than first anticipated, specially in India. "

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